Provider Demographics
NPI:1245797554
Name:GATEWAY DRUGS PLLC
Entity Type:Organization
Organization Name:GATEWAY DRUGS PLLC
Other - Org Name:GATEWAY RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLEN
Authorized Official - Middle Name:ELAYNE
Authorized Official - Last Name:DANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:239-789-7784
Mailing Address - Street 1:12401 COMMERCE LAKES DR STE 3
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-8663
Mailing Address - Country:US
Mailing Address - Phone:239-768-1222
Mailing Address - Fax:239-315-7939
Practice Address - Street 1:12401 COMMERCE LAKES DR STE 3
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-8663
Practice Address - Country:US
Practice Address - Phone:239-768-1222
Practice Address - Fax:239-315-7939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-22
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy